A 50-year-old man placed on peritoneal dialysis for end stage renal disease developed unilateral (left) scrotal edema following infusion of dialysis fluid into the peritoneum. The left side of the scrotum and left inguinal canal were surgically explored and a left hydrocele was removed. Following surgery, the patient again demonstrated left scrotal edema during peritoneal dialysis. Tc-99m MAA (5.0 mCi, 185 mBq) was injected into a 2-liter bag of dialysis fluid, which was subsequently infused into the peritoneum. The communication between the peritoneal cavity and the left inguinal canal was demonstrated.